Woman receiving vaccination

Chilly garage changes, risk-benefit calculations, and the decision to get the COVID-19 vaccine during pregnancy

Braidie is a PGY-2 (second year) Internal Medicine resident at the University of Colorado. She is currently 30 weeks pregnant and due at the end of March. This is her story about her decision to get the COVID-19 vaccine while pregnant.

In so many ways the world seemed to stop when COVID hit, can you tell us a bit about those first few weeks?

This is a big question. The simple answer is I was thinking about A LOT! When COVID “first hit” I was in the MICU (Medical Intensive Care Unit) and there was an incredible flurry of uncertainty and fear in the hospital, both from patients and health care providers. Time passed very quickly in those first few weeks and everything felt reactionary.

My husband and I were quickly doing a dance trying to minimize any risk to him when I came home from the hospital every day. There were lots of chilly garage changes and sanitizing upon re-entry home. He threatened to hose me down before letting me in but fortunately things didn’t come to that! We both isolated ourselves from family and friends pretty quickly. Undoubtedly, this was far more difficult on him as I spent some long days away from home in those first few months.

Things got tougher emotionally as death tolls rose and hospitals were closed to families, but I was incredibly grateful to a supportive husband and that, the initial fear and uncertainty in the hospital was met by an incredible camaraderie amongst all hospital staff. I was proud to go to work every day.

How has the pandemic impacted your pregnancy?

From our initial decision to conceive, to risk vs. benefits calculations of supermarket runs, seeing friends etc., COVID has definitely found a way to creep into all conversations.  

I would say the hardest thing for me has been the isolation from friends and family. We don’t live near either of our families — mine is in Canada and my husband’s is on the East Coast — which has been difficult. It is wild to think I will go this entire pregnancy without either of our families seeing me/us. I get lots of Facetime and picture requests so everyone can see my growing belly!

Professionally life is still busy and keeping me on my toes, however, in many ways, life is also a lot simpler (speaking as an extrovert who usually keeps her non-work calendar pretty full)! The biggest silver lining is that my husband and I have had a ton of quality time before the arrival of this baby. It hasn’t involved elaborate trips or celebrations but instead, hikes, walks and cozy nights at home just the two of us. I’m incredibly grateful for that.

When did you decide to get the COVID-19 vaccine?

There had been a lot of talk in early December that the vaccine would be made available to essential care workers by the end of December. However, it was uncertain whether or not pregnant or breastfeeding women would be offered it, as, not surprisingly it was not studied in these patient populations (no vaccines are initially).

Shortly after it was offered to residents and my colleagues began getting their first doses, both ACOG (American College of Obstetricians and Gynecology) and the Society for Maternal-Fetal Medicine came out with position statements in support of pregnant and breastfeeding health care workers obtaining the vaccine. Not knowing exactly what I was going to do but knowing the vaccine quantities were limited initially, I booked my first dose for the following week and used the interim to read the literature, talk with my physician and husband. I ultimately decided to move forward with the vaccine for a number of reasons, and received my first dose on the 21st of December.

What factors influenced your decision?

To start, this was not an easy decision initially and I spent some time gathering data, talking with my husband, physician and pregnant colleagues before deciding to move forward with getting the vaccine.

Ultimately, my decision was based on a couple key factors. First, we know that pregnancy is a risk factor for severe COVID-19 illness. Women are more likely to end up on a ventilator, have preterm deliveries, and have higher rates of death when compared to non-pregnant people at the same age. The risk seems to go up further along in pregnancy and is likely related to shrinking lung volumes as the baby starts to take up more space.

Just like all things with pregnancy, this is an incredibly personal decision. Your risk-benefit calculation may look different then mine depending on your profession and ability to isolate (working from home etc.). Life is already isolating enough these days, talk with your partner, friends, and physician about your decision!

Secondly, the vaccine does not contain live virus and so there is no risk of infecting baby. The good news is that our body is making antibodies against the vaccine and these can be passed to the baby transplacentally and through breast milk. This may help prevent infection!

Where are you at in the process of being vaccinated?

I completed my second dose at the beginning of January.

Can you share more about the experience of receiving the vaccine?

From a symptom standpoint the first dose was a breeze — my arm was a little sore (the most common side effect), no more so than with any typical flu vaccine. Emotionally, that was a different story. I remember looking out at the auditorium of health care workers and support staff as I waited for my mandatory “15 min” post-vaccine monitoring to be up and was so overcome with emotion. It has been a really difficult year for so many people and this represented a small glimmer of hope that we may be getting back to some sense of normalcy. That patients’ families would be able to hold their hands through their illness or be at bedside during their final moments. I am so incredibly grateful to our scientific community and to have been given the opportunity to receive the vaccine. After speaking with a number of my colleagues, I know this was a commonly shared feeling and lots of tears (no hugs, yet!) were shared in those auditoriums.

My second vaccine was less of an emotional roller coaster! I did develop some mild body aches, chills and fatigue that lasted for ~15 hours and resolved on their own. I did not develop a fever, which was perhaps my biggest concern as a high grade, sustained fever can cause risks to a developing fetus, especially during the first trimester.

What’s something you wish more people knew about the COVID-19 vaccine?

I hear a lot of people ask, “but can’t I get COVID?”. The mRNA COVID vaccines do not contain live virus and therefore cannot transmit the actual virus. They contain an inactivated protein on the surface of the virus that your body recognizes as abnormal and will make helpful virus fighting antibodies should you be exposed in the future.

Anything else you’d like to share?

I loved this shared decision making tool and know a number of physicians who are using it to guide conversations with their non-physician pregnant patients.

This interview is part of a three part series Ovia hosted with healthcare professionals about the decision to get the COVID-19 vaccine. Read other stories in the series here and here.

Updated January 27, 2021

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